Role of resmetirom, a liver-directed, thyroid hormone receptor beta-selective agonist, in managing non-alcoholic steatohepatitis: a systematic review and meta-analysis
Abstract
BACKGROUND
Resmetirom, a liver-directed, thyroid hormone receptor beta-selective agonist, has recently been approved to treat non-alcoholic steatohepatitis (NASH). This meta-analysis aimed to summarize the efficiency and safety of resmetirom in treating NASH.
METHODS
Electronic databases were searched for randomized controlled trials (RCTs) of resmetirom vs. placebo in patients with NASH. The primary outcomes were the changes from baseline in hepatic fat content, liver histology, including NASH resolution, and non-invasive markers of hepatic fibrosis.
RESULTS
Three RCTs (n = 2,231) met the inclusion criteria. Compared to placebo, resmetirom achieved greater reductions from baseline in hepatic fat content assessed by magnetic resonance imaging proton density fat fraction (for resmetirom 80 mg: MD -27.76% [95%CI: -32.84, -22.69]; for resmetirom 100 mg: MD -36.01% [95%CI: -41.54, -30.48]; P < 0.00001 for both) and FibroScan controlled attenuation parameter (for resmetirom 80 mg: MD -21.45 dBm [95%CI: -29.37, -13.52]; for resmetirom 100 mg: MD -25.51 dBm [95%CI: -33.53, -17.49]; P < 0.00001 for both). Resmetirom 80 mg outperformed placebo in NASH resolution and ≥2-point non-alcoholic fatty liver disease activity score reduction. Moreover, resmetirom 80 mg and 100 mg were superior to placebo in cytokeratin-18 (M30) reduction. Greater reductions in liver enzymes, lipids, and reverse triiodothyronine were observed in the resmetirom arms with no impact on triiodothyronine. Nausea…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,231 participants or records.
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